Community pharmacies are facing ‘unanswered questions’ about vaccine availability and appointment booking systems that make the final preparations for the winter vaccination service ‘nigh on impossible’, the National Pharmacy Association (NPA) has warned.

Flu and Covid-19 vaccinations for care home and housebound patients began this week, with other eligible patients set to begin receiving their vaccinations from next Monday.

But Gareth Jones, NPA director of corporate affairs, said that community pharmacies were ‘trapped in the starting blocks’ through ‘no fault of their own’.

‘Independent pharmacies are really good at adapting to dynamic situations, but even they are stymied right now,’ he said.

‘We have no doubt that community pharmacies will play a very significant role this season, as in previous years, but at the moment they are trapped in the starting blocks through no fault of their own,’ Mr Jones added.

And he said that the ‘to-and-fro with the start dates’ for the flu and Covid-19 vaccination campaigns ‘didn’t help’ the situation.

Community pharmacy contractor Ashley Cohen, who owns an independent group of pharmacies in Yorkshire, echoed Mr Jones’ specific concerns about issues with vaccine availability and systems to book pharmacy appointments.

While appointments at vaccination clinics can be booked from Monday 18 September, Mr Cohen told The Pharmacist that all his sites were not yet live on the National Booking Service (NBS).

He added that he was ‘genuinely worried that we will be all ready to go live by end of this week’.

And he said that the NBS would not accept bookings from patients for both flu and Covid jabs until early October, despite vaccination providers being told and incentivised to co-administer the two vaccinations from September. Mr Cohen described this as a ‘massive missed opportunity’.

Once the NBS opens, vaccination providers have just one day before they begin clinics – a move which Mr Cohen described as ‘illogical’.

And he questioned how vaccination providers could plan activity ‘when we have no idea on volume or uptake’.

He said that he expected the first week of vaccinations to be a ‘loss leader’ for his business.

In addition, he warned that some pharmacies would not have received their stock of flu vaccination by the time clinics begin next week.

‘Vaccine supply has changed, with new models on how this will be distributed, yet sites are not clear how this will work in practice,’ Mr Cohen said, adding that he did not yet know the delivery day for his vaccination sites yet.

‘The whole process this year has been a shambles,’ he said, citing concern and work around the delayed start and then the decision to bring the programme forwards which he said ‘wasted significant time for every contractor’.

‘I must have spent circa 40 hours wasted on the delay and then the last-minute change to bring forward,’ he added.

And he said he was concerned about delays in getting new sites and those that were paused onboarded to the service.

Even within Mr Cohen’s own sites, which have been involved in the programme since 2021, and which he described as ‘an agile operator of the vaccine programme’, he told The Pharmacist that ‘getting us back onboard has taken huge amounts of time and effort’.

However, he praised local vaccination programme leads for their work to support vaccination providers.

‘All the vaccine programme leads we are working with are all incredibly helpful and supportive and equally frustrated that the IT and supply and communications have been all thrown at us without any consultations,’ he told The Pharmacist.

‘We have exceptional programme leads in the Leeds area and also for York where we have clinics. But we must be getting dozens of emails each day with time critical responses needed to escalate IT and supply issues,’ Mr Cohen said.

The flu vaccination service was originally due to begin in September, but last month was changed to commence in October to coincide with Covid vaccinations.

The NPA warned that the last-minute changes could lead to losses for pharmacy owners and told NHS England that contractors had a legal basis to seek compensation.

Then, following concerns around a new Covid-19 variant, both vaccination programmes in England were brought forward to begin on 11 September for housebound and care home patients, with other eligible patients set to begin receiving their vaccinations from 18 September.